Year 12 – Health and Movement Science

5.5 Discuss the impact of drug use on injury management and improving performance

About the dot point

Drug use in sport refers to the use of substances or methods to treat illness and injury, manage pain and recovery, or deliberately enhance performance. It matters because drugs can change how an athlete’s body responds to training load, fatigue and tissue damage, and they can also alter decision-making by reducing symptoms or increasing confidence. In injury management, medication may support rehabilitation by controlling inflammation or discomfort, but it can also mask pain and remove protective warning signs, increasing the risk of returning to play before healing, strength and movement control have properly recovered. In performance contexts, performance-enhancing drugs may increase strength, endurance, alertness or recovery speed, yet they can create serious short-term and long-term health risks and undermine fair competition.

How to approach it

The directive verb in this dot point is discuss, which means you must identify key issues and provide points for and/or against. In this topic, that requires considering more than one relevant angle, such as the benefits and risks of drugs in injury management, the ways substances can improve performance, the health implications, and the ethical and testing issues linked to anti-doping rules. A strong discussion weighs how drug use may support legitimate medical care while also explaining how misuse, prohibited substances or unsafe practices can harm athletes and compromise the spirit of sport.

1. Drug use in injury management and improving performance

This section introduces the overall impact of drug use on injury management and improving performance. The teaching advice makes clear that drug use needs to be understood as both a medical issue and a performance issue, depending on why the drug is used and how it affects the athlete.

Drug use in sport can involve legitimate medical care, or it can involve the use of substances or methods to gain a performance advantage. A drug may help an athlete manage pain, recover from injury or treat a genuine medical condition. However, a drug may also be used to increase strength, endurance, alertness, recovery speed or confidence in ways that are unsafe or unfair.

The key issue is that drug use can change how an athlete feels, which can then change how they train, compete and make decisions. In injury management, drugs may reduce pain or inflammation, but they may also mask warning signs and encourage an unsafe return to play. In performance, drugs may increase strength, endurance, alertness or recovery, but they can also create serious health risks and unfair advantages.

The World Anti-Doping Agency (WADA) states that substances and methods may be included on the Prohibited List when they involve potential performance enhancement, potential health risk or violation of the spirit of sport. WADA’s 2026 Prohibited List was published in September 2025 and came into force on 1 January 2026.

Drug use therefore needs to be considered through three connected areas:

Health implications: what the drug may do to the body in the short and long term
Ethical considerations: whether the drug use is fair, safe and appropriate for the athlete’s age and situation
Drug testing: whether the substance or method breaches anti-doping rules and what consequences may follow

This means drug use is not only about whether a substance improves performance or reduces pain. It is also about whether the athlete is being protected, whether the competition remains fair and whether anti-doping rules are being followed.

1.1 Why athletes use drugs

Athletes may use drugs for legitimate medical purposes, such as injury management, treatment of medical conditions, rehabilitation and recovery. For example, an athlete may need medication to manage inflammation after an injury, treat asthma, control pain or support sleep during recovery. When this occurs under medical supervision and within anti-doping rules, drug use may be part of safe and legitimate care.

However, athletes may also use drugs illegally or unethically to enhance performance, accelerate recovery beyond natural limits, mask pain or gain a psychological advantage. This can increase injury risk because the athlete may push the body harder than it can safely tolerate. It can also create unfair competition because performance may no longer reflect training, skill and preparation.

Legal or regulated reasons

Injury management: using medication to reduce pain, swelling or muscle spasm during treatment and rehabilitation.
Treatment of medical conditions: using medication for genuine health needs, such as asthma, diabetes, infection or pain.
Rehabilitation and recovery: using medication to support sleep, reduce symptoms or allow controlled rehabilitation exercises.
Therapeutic Use Exemption (TUE): applying for permission to use a prohibited substance or method for legitimate medical treatment.
Medical supervision: using medication as prescribed and checking whether it is permitted in sport.

Illegal, unsafe or prohibited reasons

Performance enhancement: using drugs to increase strength, speed, endurance, power, alertness or body composition.
Faster recovery beyond natural limits: using substances to recover faster than the body normally allows.
Masking pain to continue competing: using drugs so an athlete can keep playing despite injury signs.
Psychological advantage: using substances to increase aggression, confidence, arousal or focus in ways that may be unsafe or prohibited.
Masking agents: using substances to hide the presence of other prohibited drugs.

A Therapeutic Use Exemption (TUE) allows an athlete to use a substance or method that is otherwise prohibited, but only for legitimate medical treatment. In Australia, TUEs are managed and approved by the Australian Sports Drug Medical Advisory Committee.

1.2 Requirements and legislations

Anti-doping rules create responsibilities for athletes and formal processes for sporting organisations. The World Anti-Doping Agency (WADA) sets the global anti-doping framework, including the World Anti-Doping Code and the Prohibited List. In Australia, Sport Integrity Australia helps implement anti-doping education, testing and enforcement.

Requirements: athlete responsibilities	Legislations, rules and policies
Do not use banned substances or methods. Athletes must check the WADA Prohibited List and understand that some substances are banned at all times, while others are banned only in competition.	World Anti-Doping Code: the global anti-doping rules created by WADA. The Code helps make anti-doping rules consistent across sports and countries.
Be available for drug testing. Athletes may be tested in competition or out of competition, depending on their sport and level.	National anti-doping policies: the rules used in Australia to apply the World Anti-Doping Code through Sport Integrity Australia and sporting organisations.
Follow testing procedures. Athletes must provide required samples, usually urine and sometimes blood, and follow the instructions of testing officials.	Drug testing protocols: formal procedures for how sample collection, analysis and reporting are conducted legally and fairly.
Apply for a TUE if medically required. Athletes who genuinely need a prohibited substance or method for medical treatment may need approval before use.	Sanctions for violations: penalties may include suspensions, bans, loss of medals, loss of results or other consequences.
Follow strict liability. Athletes are responsible for anything found in their body, even if they did not intend to break the rules.	Legal processes for investigation and appeals: athletes have processes available if a possible anti-doping rule violation is investigated or contested.

The principle of strict liability is especially important. Sport Integrity Australia states that the athlete is responsible for any substance found in their body, regardless of how it got there. This means accidental use, contaminated supplements or poor advice may still lead to an Anti-Doping Rule Violation.

2. Health implications

The teaching advice says students need to understand the health implications of specific drugs, including drugs used for pain management and drugs used to enhance performance.

Drug use has health implications because it can affect how the body responds to pain, fatigue, stress, injury and training load. Some drugs may reduce symptoms in the short term, but this does not mean the body has recovered. Other drugs may improve physical output, but they may also place unsafe stress on body systems.

For injury management, the main risk is that drugs may mask pain or reduce warning signs. This can make an athlete feel ready before strength, stability, tissue healing and movement control have returned. For improving performance, the main risk is that drugs may push the body beyond safe limits, leading to short-term danger and long-term harm.

2.1 Specific drugs used for pain management

Pain management drugs are usually used to reduce pain, inflammation or discomfort. They may be legal and medically appropriate, but they still need careful control. The major issue is that pain relief can change how much load an athlete is willing to place on an injury.

Drug or drug group	Purpose in sport or injury management	What it could result in for the athlete	Health side effects
Analgesics e.g. Paracetamol, codeine-containing medicines	Usually taken orally to reduce pain so an athlete can sleep, complete daily activities or begin controlled rehabilitation.	The athlete may feel more comfortable and move more easily, but may also underestimate the seriousness of the injury.	Short term: reduced pain awareness, dizziness, drowsiness or poor judgement. Long term: dependence risk if misused, delayed treatment if pain is repeatedly ignored.
Non-steroidal anti-inflammatory drugs (NSAIDs) e.g. Ibuprofen	Usually taken orally, or sometimes applied as gels, to reduce pain and inflammation after soft tissue injury, joint irritation or overuse injury.	A netballer with patellar tendon pain takes ibuprofen before training and completes repeated jumping drills, then has worse tendon pain the next morning.	Short term: stomach irritation, nausea, reduced pain awareness. Long term: possible kidney stress, stomach problems or delayed healing if misused.
Corticosteroids e.g. Cortisone	May be prescribed orally or injected by a medical professional to reduce inflammation in joints, tendons or other tissues.	A tennis player receives a cortisone injection for shoulder inflammation and serves pain-free, but the shoulder still lacks strength and control under match load.	Short term: temporary pain relief, possible weakening of local tissue if used poorly. Long term: tissue weakening, repeated injury risk and possible hormonal effects with misuse.
Local anaesthetics	Injected by a medical professional to numb a specific injured area, usually in medical or high-performance settings.	An AFL player has a painful finger injury numbed before a match and continues marking the ball, even though the finger cannot give normal pain feedback.	Short term: pain masking, reduced protective feedback, increased risk of worsening injury. Long term: greater injury severity if used to repeatedly play through damage.
Opioid painkillers e.g. Morphine, oxycodone, fentanyl, pethidine	Used for severe pain under strict medical supervision, often after serious acute injury or medical procedures.	A cyclist recovering from a fractured collarbone uses prescribed opioid pain relief and feels able to move more freely, but their reaction time and judgement may be affected.	Short term: drowsiness, dizziness, slowed reaction time, nausea. Long term: dependence, withdrawal issues, reduced wellbeing and ongoing misuse risk.

The key point is that pain relief should support safe recovery, not replace it. An athlete should not return to full training or competition just because pain has reduced. They need to restore strength, movement quality, load tolerance, range of motion, confidence and sport-specific skills.

Example: A netballer with ankle pain may take anti-inflammatory medication and feel able to jog. However, netball requires jumping, landing, cutting, defending and repeated changes of direction. If those actions have not been tested safely, the athlete may still be at high risk of re-injury.

2.2 Specific drugs used to enhance performance

Performance-enhancing drugs are used to improve physical or psychological output. They may increase strength, endurance, alertness, recovery speed or body composition. These effects can seem attractive to athletes, especially in competitive environments where small improvements can affect selection, contracts or results.

However, performance improvement from prohibited drug use often comes with serious health risks. A drug may help an athlete train harder, but it may also increase cardiovascular strain, disrupt hormones, increase mental health risks or hide the body’s normal warning signs.

Drug or drug group	Purpose in sport or performance	What it could result in for the athlete	Health side effects
Anabolic agents e.g. Testosterone	Usually injected or taken orally to increase muscle size, strength, power and recovery.	A sprinter uses anabolic steroids during pre-season and improves gym strength quickly, creating an unfair power advantage on race day.	Short term: acne, aggression, mood changes, increased blood pressure. Long term: heart disease risk, liver damage, hormonal disruption, infertility risk and mental health effects.
Stimulants e.g. Amphetamine, cocaine	Usually taken orally, inhaled or otherwise consumed to increase alertness, aggression, focus or delay fatigue.	A basketball player uses a stimulant before a final and feels more alert and energised, but becomes over-aroused and ignores signs of heat stress.	Short term: increased heart rate, anxiety, overheating, poor sleep. Long term: dependence, cardiovascular strain, ongoing sleep and mood disruption.
EPO and related erythropoiesis agents	Injected to increase red blood cell production so more oxygen can be transported to working muscles.	A road cyclist uses EPO during a heavy training block and can hold a higher pace for longer climbs, creating an unfair endurance advantage.	Short term: thicker blood, increased blood pressure, headache. Long term: increased risk of blood clots, stroke or heart problems.
Growth hormone-related substances	Usually injected to influence muscle growth, tissue repair or body composition.	A rugby union player uses human growth hormone while recovering from a hamstring injury to try to return faster than normal healing would allow.	Short term: swelling, joint pain, fluid retention. Long term: metabolic disruption, abnormal tissue growth and increased strain on organs.
Beta blockers	Usually taken orally to reduce heart rate, tremor and anxiety in precision sports.	An archer takes propranolol before competition to reduce hand tremor and feel steadier during aiming.	Short term: fatigue, dizziness, reduced heart rate. Long term: reduced exercise tolerance and possible cardiovascular concerns if misused.
Diuretics and masking agents	Usually taken orally to increase fluid loss, reduce body mass quickly or hide the presence of another prohibited substance.	A boxer uses furosemide before weigh-in to rapidly drop body mass, then competes dehydrated and poorly recovered.	Short term: dehydration, dizziness, electrolyte imbalance. Long term: kidney stress, poor recovery and serious fluid balance problems.

WADA’s 2026 Prohibited List includes categories such as anabolic agents, peptide hormones and growth factors, hormone and metabolic modulators, beta-2 agonists, diuretics and masking agents, stimulants and narcotics.

Example: A cyclist who uses EPO may improve endurance because their blood can carry more oxygen. However, thicker blood also increases cardiovascular risk. This means the same drug that may improve performance can also increase the risk of serious harm.

3. Ethical considerations

The teaching advice says ethical considerations may include fairness of competition, safety of athletes and age.

Ethical considerations are about what is right, fair and safe in sport. Drug use is an ethical issue because it affects more than one athlete. It can affect opponents, teammates, coaches, selectors, spectators and the reputation of the sport.

3.1 Fairness of competition

Fairness of competition means athletes should compete under the same rules, with results based on training, skill, preparation, decision-making and effort. Prohibited drug use challenges this because it may give one athlete an advantage that others do not have and are not allowed to use.

This affects the meaning of results. If an athlete wins because of prohibited performance enhancement, the result does not fully reflect their natural ability or preparation. It may also deny clean athletes medals, selection, contracts or recognition.

Example: If one sprinter uses anabolic agents to increase power while others compete clean, the race is no longer fair. The clean athletes may have trained properly and followed the rules, but they are competing against an artificial advantage.

Fairness is also important for trust. Sport relies on athletes, coaches and spectators believing that results are genuine. When drug use becomes common or suspected, confidence in performances and records is damaged.

3.2 Safety of athletes

Safety of athletes is an ethical issue because sport should not pressure athletes into harming themselves for short-term results. Coaches, medical staff and sporting organisations have a duty of care to protect athlete health, especially when injury, pain, selection pressure or career pressure is involved.

Drug use can become unsafe even when the substance is legal, if the purpose is to keep an athlete competing when they should be recovering. Pain relief, for example, may be appropriate in rehabilitation, but it becomes ethically concerning if it is mainly used so an athlete can ignore injury signs.

Example: A rugby league player may want to play in a final despite a painful shoulder injury. If medication is used only so the player can tolerate contact, the decision may place the athlete at greater risk of long-term damage. The ethical issue is not just whether the drug is legal. It is whether the athlete’s welfare is being protected.

Safety also applies to performance-enhancing drugs. An athlete who uses stimulants, anabolic agents or EPO may be trying to improve performance, but they may also be placing major stress on the cardiovascular, hormonal or mental health systems.

3.3 Age

Age is an important ethical consideration because younger athletes are still developing physically, mentally and socially. They may also be more vulnerable to pressure from coaches, parents, peers, older athletes, social media or selection systems.

Younger athletes may not fully understand long-term health risks, supplement contamination, strict liability or the difference between legal to buy and legal in sport. They may also copy what older athletes do without understanding the consequences.

Example: A 16-year-old representative athlete may start taking a gym supplement because older teammates use it. They may assume it is safe because it is sold in a shop. However, supplements can contain substances banned in sport, and under strict liability the athlete is still responsible for what is found in their body. Sport Integrity Australia warns that everyday medications and supplements can contain substances banned in sport.

This is why education and supervision are important. Young athletes need clear guidance about medications, supplements, TUEs, testing and the health risks of performance-enhancing drugs.

4. Drug testing

Drug testing is used to detect and deter the use of prohibited substances and methods. It also helps protect clean athletes by supporting fair competition and athlete safety.

4.1 Who is in charge

At the global level, WADA sets the main anti-doping rules through the World Anti-Doping Code and the Prohibited List. The World Anti-Doping Code harmonises anti-doping regulations across sports and countries that have accepted the Code.

In Australia, Sport Integrity Australia is responsible for anti-doping education, testing and enforcement processes. National anti-doping policies apply the Code within Australian sport.

4.2 How drug testing usually works

Drug testing is also called doping control or sample collection. It usually involves urine and sometimes blood samples. Athletes may be tested in competition or out of competition, depending on the sport, level of competition and testing programme.

The process usually follows these steps:

the athlete is notified that they have been selected for testing
the athlete reports to the testing area and remains under observation
the athlete provides a urine or blood sample
the sample is sealed and documented
the sample is sent to a WADA-accredited laboratory
the laboratory analyses the sample
if a prohibited substance is detected, further processes may occur, including investigation and possible sanction

Sport Integrity Australia explains that urine and blood samples are sent with a de-identified form to a WADA-accredited laboratory for analysis or storage for future analysis.

Drug testing must also follow fair procedures. Athletes have rights, such as the right to ask questions and usually the right to have a representative present. They also have responsibilities, such as following instructions, providing identification and completing the sample collection process.

4.3 Consequences of an Anti-Doping Rule Violation

If an athlete is caught using a prohibited substance or method, this is called an Anti-Doping Rule Violation. The consequences can be serious because anti-doping rules are designed to protect fair competition, athlete safety and trust in sport.

The possible consequences depend on the substance, the situation, the athlete’s level of fault and whether it is a first or repeated violation. However, consequences may include:

disqualification of results, meaning the athlete’s result from a competition or event may be cancelled
loss of medals, points and prizes
a period of ineligibility, meaning the athlete may be suspended or banned from competing for a set period
provisional suspension, meaning the athlete may be temporarily stopped from competing while the case is being resolved
loss of selection, contracts, sponsorship or funding
damage to reputation, even if the violation was unintentional
public disclosure, once the matter is finalised under the relevant anti-doping rules

In Australia, the National Anti-Doping Policy states that an Anti-Doping Rule Violation connected with an in-competition test automatically leads to disqualification of the result from that competition, including forfeiture of medals, points and prizes. It also outlines sanctions such as periods of ineligibility, which may be longer for intentional or repeated violations.

These consequences show why strict liability matters. An athlete may still face serious consequences even if they did not intend to cheat. For example, a contaminated supplement or an unapproved medication can still create an anti-doping problem if a prohibited substance is found in the athlete’s body.

Example: A sprinter wins a race but later tests positive for a prohibited stimulant taken through a pre-workout supplement. Even if the sprinter did not mean to cheat, the result may be disqualified, the medal may be lost and the athlete may face a suspension while the case is investigated. The effect goes beyond one race because it may also damage selection chances, team trust and reputation.

4.4 Benefits and limitations of anti-doping

Anti-doping is important because it helps protect fair competition, athlete health and trust in sport. However, it is not perfect. Drug testing cannot test every athlete all the time, and some substances or methods may be difficult to detect. This means anti-doping works best when testing is supported by education, strong sporting culture, medical guidance and clear athlete responsibilities.

Benefits

Protects fairness: athletes are expected to follow the same rules, so results are more likely to reflect training, skill and preparation.
Protects athlete health: many prohibited substances carry serious short-term and long-term health risks.
Deters drug use: athletes may be less likely to use prohibited substances if they know they can be tested in and out of competition.
Detects rule violations: testing can identify prohibited substances or methods and allow sporting organisations to apply consequences.
Supports trust in sport: athletes, coaches and spectators are more likely to believe results are genuine when anti-doping systems are in place.
Encourages careful medication and supplement choices: athletes are more likely to check substances before using them.

Limitations

Not all athletes are tested equally often: elite athletes may be tested more regularly than recreational or lower-level athletes.
Some drugs may leave the body quickly: timing can affect whether a substance is detected.
New substances and methods may emerge: anti-doping rules and testing procedures need regular updates.
Supplement contamination can still occur: an athlete may unintentionally use a banned substance through a contaminated supplement.
Testing cannot remove all pressure to use drugs: athletes may still feel pressure from selection, performance expectations, injury, contracts or competition results.
Testing is only one part of clean sport: education, medical advice, coaching culture and athlete decision-making are also needed.

Brief Summary

About the dot point and how to approach it

Drug use in sport refers to substances/methods used to treat illness and injury, manage pain and recovery, or deliberately enhance performance.
The verb discuss requires identifying key issues and providing points for and/or against, considering benefits and risks in injury management and performance, health implications, and ethical and testing issues linked to anti-doping rules.

1. Drug use

Drug use can involve legitimate medical care (injury management/treatment/rehabilitation) or using substances/methods to gain a performance advantage.
In injury management, medication may support rehabilitation by controlling inflammation/discomfort, but can also mask pain and remove protective warning signs, increasing risk of returning before healing, strength and movement control recover.
In performance contexts, performance-enhancing drugs may increase strength, endurance, alertness or recovery speed, but create serious short- and long-term health risks and undermine fair competition.
WADA includes substances/methods on the Prohibited List for potential performance enhancement, health risk or violation of the spirit of sport; athletes have responsibilities under anti-doping rules and strict liability.
A Therapeutic Use Exemption (TUE) allows an athlete to use an otherwise prohibited substance/method for legitimate medical treatment.

2. Health implications

Drug use can affect responses to pain, fatigue, stress, injury and training load; reduced symptoms do not mean the body has recovered.
Pain-management drugs can change load decisions and mask pain, increasing risk of returning before key capacities (strength, movement quality, load tolerance) are restored.
Performance-enhancing drugs may improve output but can cause serious harms (cardiovascular strain, hormonal/metabolic disruption, mental health risks).

3. Ethical considerations

Ethical issues focus on what is right, fair and safe in sport, affecting others and the reputation of the sport.
Prohibited drug use affects fairness of competition because it may give one athlete an advantage that others do not have and are not allowed to use.
Drug use is an ethical issue for safety of athletes (duty of care), including when pain relief is used so an athlete can ignore injury signs, or when performance-enhancing drugs place major stress on body systems.
Age matters because younger athletes may be more vulnerable to pressure and may not fully understand long-term health risks, supplement contamination or strict liability.

4. Drug testing

Drug testing detects and deters prohibited substances and methods, protecting clean athletes by supporting fair competition and athlete safety.
WADA sets the Code and Prohibited List; in Australia Sport Integrity Australia supports anti-doping education, testing and enforcement processes.
Drug testing usually involves urine and sometimes blood samples conducted in competition or out of competition with laboratory analysis.
Anti-Doping Rule Violations can lead to disqualification/loss of results and periods of ineligibility under strict liability
Anti-doping has benefits and limitations (e.g. not all athletes tested equally, detection challenges, supplement contamination).